How is osteoporosis treated?

As already discussed, evaluation of calcium intake and consideration of estrogen replacement therapy are both very important. Activity level and postural advice are important as well. Physical therapy can be very helpful in reducing acute symptoms and teaching the patient exercises to maintain or regain extension (natural arch) of the spine. Often people who have had multiple compressions have gradually developed a “dowager’s hum,” or increased thoracic kyphosis. This rounded-back posture results in increased pain in the neck and upper back and predisposes to further vertebral compression in the spine. In early to middle stages, at least some of this posture may be reversible. Exercises which encourage extension can reduce progression of compression fractures whereas those which encourage flexion (bending) of the spine have actually been shown to increase the rate of fracture.

As mentioned above exercises which “load” the arms are important as well. An example is shown below.

In addition, corsets can be very useful in supporting and maintaining the patient’s posture.

Are other medications useful in osteoporosis?

Often there is secondary muscle spasm or inflammation; in these situations, medications by mouth or injection can be useful to treat secondary effects of the vertebral compression. In addition, medications which reduce pain can help the patient reduce immobility and return to his/her prior activity level, thus, reducing untoward effects of prolonged immobilization. It is vital that, after the acute stage, the patient begin a regular exercise program, often under the supervision of a physician or physical therapist, to return to a better level of fitness and reduce progression of osteoporosis.

Calcitonin and etidronate are drugs which, at the time this was written, seemed to hold promise for the future as medications to reduce or even reverse bone loss. Vitamin D and fluoride, studied and discarded, are stimulating new interest by researchers of late. The search for a safe, effective medication continues.

In Summary:

Osteoporosis is a common process in the aging population. This can result in vertebral compression, postural abnormalities, as well as fractures of the wrist and hip. These conditions are associated with pain and disability, as well as increased mortality. Aggressive conservative management can reduce pain and disability in many cases and return the individual to a better quality of life.

Compression Load Exercise:

Stand facing a wall, with your feet slightly apart and your arms bent at the elbows to 90 degrees. Lean forward, falling toward the wall, restraining the fall with your hands. Push body back to starting position. Repeat 10 times.